(0502) A Systematic Review of the Role of Hyperbaric Oxygen Therapy in Nasal Surgery

Introduction: Hyperbaric oxygen therapy (HBOT) has shown promise as an adjunctive treatment in nasal surgery, yet lacks a well-defined protocol with specific treatment parameters and outcomes. This study aims to systematically review reported cases involving HBOT for healing in nasal surgery and to determine its efficacy.

Methods: In a June 2023 search using PubMed, Embase, and other databases, studies were included if they contained (1) nasal surgery patients, (2) treatments with adjunctive HBOT pre and/or postoperatively, (3) HBOT treatment parameters (duration, atm, number of treatments), and (4) final clinical outcome was reported. Exclusion criteria consisted of studies unavailable in English, with only a single HBOT session, an absence of treatment parameters, and zoological, review, and editorial articles. Extracted data included patient demographics, any comorbidities, surgery type, indications for HBOT, and HBOT atm, session number and duration, outcomes, and complications.

Results: Of 71 articles, 20 underwent full-text review, and 7 were included for data extraction. Additionally, 2 were retrospective chart reviews, and 5 were case reports. A pediatric population (mean 5.13 years) was reported in 3 studies, while 5 had adult populations (mean 47 years). Nasal surgeries included replantation, flaps, reconstruction, and rhinoplasty. In all studies, adjunctive HBOT was employed with vascular compromise as the main concern. Mean pressure was 2.4 atm (range 2 to 2.5 atm), and average duration was 88 min/session (range 60 to 120 min/session). Mean total session number was 15 (range 6 to 30 sessions), with at least one session daily. Notably, HBOT was initiated within a postoperative window of 6 to 24 hours. No complications were noted, and all studies highlighted marked cosmetic improvement with good graft survival after HBOT, with graft survival rates of 80-97.3% in two studies.

Conclusions: Current evidence suggests HBOT is effective in promoting revascularization and favorable outcomes in challenging nasal surgeries. Further research and standardization are needed to establish a therapeutic algorithm for HBOT in nasal surgeries.